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April 14, 2024
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Transcranial Magnetic Stimulation
Today, millions of Americans struggle with substance use disorders. In 2021, an estimated 46.3 million of us qualified as having a substance use disorder or addiction. For many of us, that means that treatment and a long uphill road of therapy, counseling, and group support. Increasingly, we also have access to more tools to aid that treatment, and one of those is Transcranial Magnetic Stimulation.
TMS or Transcranial Magnetic Stimulation is a tool which you can use to improve recovery outcomes. It’s also FDA approved for treatments including smoking cessation and for treating depression. At Stairway Resource Center, we offer TMS as a complementary treatment to our group therapy and 12-step addiction treatment programs, to add to your treatment and help you to recover.
What is TMS?
Transcranial Magnetic Stimulation uses a magnetic coil and exposure to magnetization, typically directly to the head and brain. It’s extremely similar to an MRI in that it generates a weak magnetic pulse, which generates an even weaker electronic pulse in the brain. The result affects the cellular and hormonal response of treated brain tissue, which can change reactions.
Most notably, that’s used to temporarily alleviate symptoms of depression. For example, TMS is FDA approved as a third-line treatment for depression. It’s also FDA approved for aiding in smoking cessation, as it can help patients to better control mood – therefore reducing cravings for cigarettes. TMS was approved by the FDA for treating cravings in cigarette smokers in 2021.
What Does TMS Treatment Involve?
Transcranial Magnetic Stimulation is almost always used as a complementary therapy. This means that you get it in addition to behavioral therapy and counseling. The intent is to use it as a tool to make recovery easier, not that it will cure you of addiction. In most cases, treatment involves 20-40 minute sessions. The FDA approved NeuroStar TSM machine requires a 40 minute session 5 days per week for 6 weeks. The Brainsway DTMS is a 20 minute session intended to be administered 4 days per week for 4 weeks and then twice weekly for an additional 12 weeks.
During those sessions, magnetic pulses are administered to the brain, which changes neuron activity related to depression and low mood. This, in turn, should make it easier for you to stay clean and sober.
Depending on which TMS treatment you get, you can also end up in treatment for as much as 4 months. In some studies, that treatment results in 30-40% remission rates of depression – making it ideal for dual-diagnosis treatment. In clinical trials, smokers receiving TMS were more than twice as likely to maintain quitting as participants receiving placebo treatment. In addition, follow-up trials show that results remain for at least 16 weeks after treatment ends, giving you time to benefit from primary therapy and treatment to better manage your symptoms and your mental health.
TMS for Substance Use Disorder
Transcranial Magnetic Stimulation was originally approved by the FDA to treat depression in 2008. Since then, multiple TMS devices have been approved, primarily for third-line treatment. This means that after the patient has failed 2 or more primary treatment methods or has shown to be not responsive to them. E.g., to medication. It’s also approved to help patients treat cigarette use disorder. With studies showing that TMS can more than double quit rates, transcranial magnetic stimulation can have a significant impact on your recovery journey.
Here, TMS is thought to work by:
Reducing Depression
TMS temporarily reduces neuron activity, which can reduce low mood and depression. Patients receiving TMS report more positive mood and fewer episodes of feeling down. This is not a permanent effect. Therefore, it can help you to alleviate the downturn in mood that many people face when quitting drugs and alcohol. You might be able to use TMS to feel better in and during your recovery. However, the effects are not permanent. Still, that boost will help you to move through recovery by reducing the obstacles you have to get through to stay clean and sober.
Reducing Cravings
TMS can potentially reduce cravings by reducing neuron activity related to experiencing cravings. That can also reduce withdrawal symptoms. In one meta study including 278 patients for 16 weeks, patients who received TMS reported lower cravings in self-assessment surveys. Participants also smoked significantly fewer cigarettes per week than individuals simply receiving the placebo treatment despite having comparable levels before treatment.
Essentially, TMS can help you to boost mood and to reduce cravings. Those can combine with your normal behavioral treatment, counseling, and 12-step treatment to give you the best possible chance of recovery.
Dual Diagnosis Treatment with TMS
TMS is also a primary choice for dual diagnosis treatment. For example, if you have a depression diagnosis, your mental health disorder can interfere with your substance use disorder treatment. Tools like Transcranial Magnetic Stimulation can help you to alleviate the symptoms of depression, giving you the space to focus on treatment, so you can recover. That offers more room to get treatment at a pace that makes sense for you and for your recovery.
Here, we combine TMS with other forms of treatment, so you can tackle the symptoms of depression, the behavior patterns that exacerbate it, and work to improve your health all at once.
Who is TMS For?
Transcranial Nerve Stimulation is a treatment that you can have your doctor prescribe. If you attend Stairway Resource Center, it’s part of our treatment package and may be recommended to you as part of your program. However, in each case, we’ll work with you, your medical history, and your symptoms to make the best possible recommendation for your needs. For example:
- You may not be recommended TMS if you have a history of seizures
- Your insurance may not cover TMS until you’ve tried other methods of treatment, in this case, we’ll work with you to ensure you get the best coverage
- You may want TMS to complement behavioral therapy
- You may not be able to combine TMS with your medication or with withdrawal from benzodiazepines or alcohol although our doctors can work with you to offer recommendations on a case-by-case basis.
- You won’t be able to use TMS if you have metal implants or stents in your jaw or skull
- TMS is not recommended for individuals with brain tumors
- TMS treatment is not recommended if you use psychedelics such as ecstasy
- TMS is not suitable if you’re being treated for cocaine use disorder
- We’ll review your medical history for signs of or risks of stroke before recommending the treatment
TMS was approved by the FDA in 2008. Today, it’s FDA approved for multiple uses. This means that if you want to opt into treatment, all you have to do is talk to us and we’ll discuss your potential outcomes, the risks and benefits of the treatment, and your insurance coverage.
What Is a Transcranial Magnetic Stimulation Session Like?
Going to a transcranial magnetic stimulation session can seem like a lot. However, sessions are predictable. In addition, it will probably include the following steps:
Safety Check
You’ll be asked to remove anything magnetic such as keys, earrings, electronic devices, etc. Then, your technician will do measurements, properly fit the coil, and redo your motor threshold test, although you won’t likely re-do it every single session. The motor threshold test usually means checking how much magnetic pulse is required to make your thumb twitch. This varies per person. Normally a “dose” is about 120% of the dose required to cause a thumb twitch, or enough to exceed causing neural activation.
Exposure Session
Some but not all TMS sessions include an exposure session. Here, you spend a brief amount of time thinking about triggers for cravings. This is sometimes called the “provocation period” and typically lasts about 5 minutes.
Session
The machine will pulse for 20-40 minutes against your scalp. You shouldn’t feel any pain. However, you will likely find it uncomfortable. You will adjust to having to sit still. However, most patients still report discomfort at their fingers and toes twitching. Otherwise, you shouldn’t experience any discomfort at all.
Following treatment, you can get up and immediately go home. You won’t have to wait around to make sure you’re okay. You’ll also be able to drive if you want to.
Are There Side-Effects or Risks?
Transcranial Magnetic Stimulation has no reported long-term side effects. However, there are short term side effects, and it is important that you be aware of them.
For example, some people experience:
- Headaches for a few hours after sessions
- 20+ minutes of lightheadedness after sessions
- Discomfort at the magnet site
- Twitching facial muscles
- Eye pain (rare)
- Dental or jaw pain (rare)
- Seizures (rare)
Some patients have also been shown to be more susceptible to catching the common cold or to responding badly to allergies immediately after treatment. Therefore, it’s generally recommended to mask when traveling to and from sessions unless you’re in a private vehicle. If you’re staying at our treatment facility, you won’t have to worry about this.
If you have symptoms, report them to your technician. If we feel the symptoms are too high, we’ll reduce the intensity of the treatment to reduce the symptoms.
In addition, most people are not at risk of seizures. However, if you abuse alcohol, cocaine, some psychedelics, have schizophrenia, epilepsy, or bipolar disorder, it’s not usually recommended to use TMS. Therefore, we ask you to be open and candid about your medical history when signing up for the treatment.
Getting TMS Treatment at Stairway Resource Center
If you’re struggling with substance use disorder, Transcranial Magnetic Stimulation can help you to reduce cravings and boost your mood. That can, in turn, help you to better focus on your recovery and to stay in recovery. Of course, Transcranial Magnetic Stimulation isn’t for everyone. It’s important that you have a discussion with us to make sure it’s a good fit. However, it can be the tool you need to help you through behavioral therapy and primary treatment so you can get clean and sober.
TMS is an FDA approved treatment and Stairway Resources Center is proud to offer it as part of our toolkit. If you want to learn more, contact us about using Transcranial Magnetic Stimulation for addiction treatment or dual diagnosis treatment.
